Respirator



y 2, 1933- P. DRINKER ET AL 1,906,453

RESPIRATCR Filed Nov. '25, 1931 2 Sheets-Sheet l May 2, 1933.

P. DRINKER ET AL 7 1,906,453

REsPiRAToR Fil'ed Nov. 25, 1931 2 Sheets-Sheet 2 l munuu IIIIIIIII III|III INVENTOR Pfl/l/P aim/#56 AND 400 5 sass/z s/v/m/ Patented May 2, 1933 UNITED STATES PATE NT OFFICE rum nRmxRa Am) LOUIS acas'siz smw, or BOSTON, massacnusarrs, assumone BY mun assrcnums ro WARREN a. comma, wamn a. comma, JR... m WALTER a. cmcx, an. or aosron, mssacnusm-rs BESPIBA'IOB Application filed November. 25, 1931. Serial No. 577,178.

The present invention relates to apparatus for use in aiding or artificially producing respiration. Emergency cases of drowning,

as poisoning, electric shock and the like ave long been treated by artificially inducing respiration to yentilate the lungs until the patient recovers sufiiciently to breathe naturall By the use of the invention describe in our copending application, Serial Number 380,271 filed July 23,

1929,. it has been possible within the last two years to use artificial respiration successful in pathological cases of poliomyelitis, di theritic paralysis, drug poisoning, and asp yxia neonatorum, where artificial respiration complete or in part, for rolonged periods has been necessar uch extension of artificial respiration has brought comfort to and has saved the lives of many patients otherwise doomed to immediate painful death by suffocation all of which has been rendered possible through the invention described in the above-noted application.

The present invention has for an object to provide an improved apparatus for producin artificial res iration of a type designec? more particu arly for treating newborn infants and very small children, although certain features of the a paratus are applicable likewise to the ad t forms of respirator as will be apparent as this description proceeds.

For the ifpurposes of disclosure of the principles 0 the invention an infant model respirator designed more particularly for treating asphyxia neonatorum and having readily controlled effective means for roducing and maintaining respiration w ile supporting the infant in osition to facilitate draining of mucous rom the air passa is described herein. a

he invention aims, for example, to. provide arrangements for facilitating the draining ofthe air passage during the first few minutes after birth, and to provide .an air--' rti ht seal around the neck of the atient w ich will be suitably adjustable an comfortable and will not-restrict the'neck.

Asphyxia neonatorum occurs in about 5% of all births and is a major obstetrical problem., If these deeply asphyxiated new-born babies whose hearts are beating but whose respiratory mechanisms are inactive can be kept alive by artificially ventilating the lungs without injury to the delicate tissue thereof long enough they will develop, in a majority of cases, normal respiratory activity.

The present invention provides an apparatu's which makes possible and convenient 'the treatment of such infants by 'a method which applies no undue strain on either the lung tissues or the muscles of the body. In-

fants weighing from four to ten pounds at birth have been successfully treated in the apparatus, it having been necessary in some cases to continue the artificial respiration for more than half an hour before natural rhythmic breathing occurred.

The method of treatment in the apparatus of the present invention involves causm respiration by subjecting the chest, exteriorly, to a partial vacuum and causing expiration by releasing such vacuumor, 1f necessary because of lack of tone of the muscles, by applying a positive pressure to the chest. The apparatus herein described for the purposes of illustration is so designed that the body and legs of the atient are enclosed in a practically 'air-tig t casing while the head and neck project through one end wall to expose the mouth and nose to air at atmospheric pressure. v

.The nature andobjects .ofthe invention will be better understood from a description of a particular illustrative apparatus for .the purpose of which description reference should be had to the accompanying drawings forming a part hereof and in which- Figure 1 is a central sectional and some 4 what diagrammatic view of an apparatus embodying the invention,

,Fig. 2 is a side view of the complete apparatus, h

Fig. 3 is a sectional detail view showing the arrangement'for adjusting the inclination of the body support within the casing anld of. the casing re ative to the base,

means being provided for forming an airtight seal around the neck.

A power plant 10'convenientl mounted on a shelfof the wheeled carriage is ar-,

ranged to produce the desired fluctuations of air pressure within the casing to which it is connected by a flexible air conduit 11.

The body support is shown as a bed, provision being made for varying the inclination of the bed in order to facilitate draining of the air passages as is desirable in treating new-born infants. As shown, the foot end of the body support is hingedly supported at 12 and thehead end is secured in adjusted position by means of a push rod 13 passing through a stufling box 15 which can be tightened to hold the rod in adjusted position. A flexible collar 16 forms an airtight seal around the face of the end wall 17 of the casing for accommodation to the position of the atient. Exteriorly of the casing the head 1s supported on an adjustable head support 18 which is secured in adjusted position by clamps 19 and 20 and the rod 21. The collar 16 is shown as made in the form of a thin flexible sheet which can bedrawn taut and held in position by so thin as .to be easily torn during the .necessar manipulations and the outer pormeans of a ring 22 and four clamps 23. The clamps may beof any suitable form. As shown, they are supported on headed pins 25 about' which they pivot and they are tightened bymeans of thrust screws 26. A collar of referred form made of rubber of good qua-ity is shown in cross-section in Fig.5. The central aperture may be only an inch or two in diameter when the collar is contracted but when it is applied about the neck of the patient it is stretched radially until it fits comfortably but tightly around the neck of the patient and then it is clamped by the ring 22 and clamps 23 in thedesired position. By the use of four clamps '23 operating onthe ring 22, it is possible to adjust the clamps to old about three-fourths of the diameter of the collar while still permitting adjustment of the other one-fourth. As shown, the central portion of the collar is relatively thin but not tions w ich are engaged by the clamping ring 22 are somewhat thicker the better to resist dama e by the clamping. Immediately aroun the edge of the central aperture a slight bead 28 is formed to resist tearing. The same type of collar and adjustment thereofis used on adult as well as infant respirators.

The rubber collar is made large enough so that .it can. be clamped in eccentric position relative to the aperture in the end wall thereby providing for adjustment along. the face of the end wall of the casing to a osition corresponding to the position 0 the body support and head rest.

The arrangement of the adjustable body support with the adjustable head rest and adjustable air seal fittin around the neck make it convenient to ti t the body of the patient the desired amount in order to satisfactorily drain the nasal passages. "Ordinarily a relatively slight inclination is sulficient and the casing is designed on this basis,

but in order to permit further inclination.

of the patient in exceptional cases or to permit variation of the inclination without disturbing the patient, the casing as'a whole is made tiltable on its support. To this end the casing is hinged as indicated at 30 to a base which is mounted on or forms the top of the wheeled carriage or stand. The-casing at its other end is adjustably supported in position by a pair of extensible legs 32. These legs are shown as formed with the telescoping rod 33 which can be adjustably positioned in its sleeve. and secured in adjusted position as by means of suitable set screws. The cover 40' of the casing may conveniently be hinged" at one edge so that it may be lifted by the handle 41 for placing or removing the patient and for attention, if necessary. The hinged cover is secured in closed osition by a number of clamps 43 or any ot er desired clamping means and a rubber gasket 44 insures an air-tight seal when the cover is closed.

Observation of the patient is facilitated by air-tight glass or celluloid. observation windows 45 and lights 46 within the casing. Aluminum can be substituted in these windows forithe purpose of taking X-ray photographs if desired. I

The manometer 50 mounted on the exterior of the casing is connected to the interiorof the (lasing by means of a hose 51 in order that the pressure within the casing -whether positive or negative may be observed by the attendant as the pressure fluctuates. The manometer also automatically serves as a safety device 'to prevent excessive pressure, since in case of excessive pressure or vacuum theliquid in the ma- 'nometer will be discharged and provide an opening for admission or exit of air. In order to facilitate the adjustment of the liquid level in the manometer .a small leveltions of pressure within the casing to induce respiration, is suitably mounted on the carriage. As shown, it is mounted on a base 57 which is insulated from a second base 58 by means of a rubber pad 59 and in turn the base 58 is supported on rubber block 60 to deaden thevibration. The power plant, as

shown,-comprises a motor 61 drivin a suction fan 62 to the inlet of which t e conduit 63 is connected and to the outlet of which is connected a conduit 64 and muffler 65. Between the conduit 63 and the muflier 65 is arranged a valve 66 which is rotated by a worm 67. driven by the motor 61. The valve ports are so arranged that during rotation of the valve connection is established alternately, first between the conduit 11 and the conduit 63 to exhaust air from the casing, and then between the conduit 11 and the discharge end of the muflier 65 thru port 70 to permit the intake of air into the casing thru the muflier discharge outlet at 71.

- It may be desirable attimes to alternately appl suction and pressure in which case the discharge outlet 71 of the muflier may be closed or partially closed whereupon connection of the conduit 11 with the ort 70 will cause ressure to be applied wit in the casing. T e speed of .the motor may be varied .by means of a suitable rheostat. The variation of pressure used in the treatment of infants does not generally exceed 10 cm.

of water. In most cases the pressure is alternated between atmospheric pressure and sub-atmospheric ressure but occasionally it is found desirab e to apply pressures alternatinfg between positive and negative.

The oregoing particular description is illustrative merely and is not intended as defining the limits of the invention. Obviously many changes may be made without departing from the spirit of the appended claims. I

We claim 1. In an apparatus for producing artificial respiration a casing to receive the body of the patient, an opening in one wall thereof through which the head of the patient may project, means for perio'dically'varying the pressure within the casin a seal for said opening comprising a flexib e rubber collar having an opening to fit around the patients neck and means to clamp the outer edges of said collar to the casing wall, said collar being elastic to permit stretching by pulling on its outer edges to enlarge the opening and provide a comfortable fit around the atients neck and said clampingmeans being' adjustable to clamp and hold the collar in its stretched position.

2. A rubber collar for forming a seal be tween the neck of a patient and the wall of an artificial respirator casing having a relatively thin and elastic central portion with an opening to fit around the patients neck, the edge of which opening is beaded to resist tearing, the outer portion of the collar being thicker'to resist tearing when pulling to ad'ust-Jahe position of the collar and to stretch the' opening.

3. In an apparatus for producin artificial respiration, a casing to receive t e body of the patient, an opening in one wall thereof through which the head of the patient projects, means to seal said opening around the patients neck comprising an adjustable and stretchable collar consisting of a sheet of flexible material having an opening therein to fit around the patients neck, clamping means around the opening in the casing wall to secure said collar in position, said clamping means permitting bodily adjustment of the opening in the collar relative to the opening in the casing wall, said clamping means also permitting stretching of the collar to give a ood fit around the patients neck and providing means to clamp the collar in stretched position and means to periodically produce variations of pressure within said'casing.

' 4. In an apparatus for producing artificial respiration, a casing to receive the body of the patient, an opening in onewall thereof through which the head of the patient projects, means to produce periodic variations in pressure within said casing and means to provide a seal for said opening comprising a stretchable rubber collar adapted to fit around the atients neck and be clamped'to the wall 0 said casing, and clamp means at a plurality of points around the opening in said casing wall to position.

5. In an apparatus for producing artificial respiration, a casing to receive the body of the patient, havin an opening in one wall thereof through w ich the head of the paclamp said collar in adjusted and stretched tient projects, means to periodically vary the ressure ",m said casing, and means to prov de a seal around the patients neck comprising a sheet of rubber material having an openin therein and means to clamp said sheet to e casing wall through which the patients ead projects, said clam ing means permitt g bodily adjustment 0 the position of said collar andalso permitting portions of said collar to be stretched and moved relative to. other portions of said collar, and permitting said portions to be clamped in said stretched positions.

6. In apparatus for producing artificial res iration a casing adapted to receive the b0 y of a patient with-"the head projected therefrom, said casin having. a hinged; cover and means for forming an air-tight 'seal when said cover is closed, a body sup.- 7

port within saidcasing inclined downward- I y toward the head end thereof, means for varying the inclination of said body sup- 5 port, a stretchable and adjustably positioned flexible collar arran ed to form an air-tight seal around the nee of the patient, means for clamping said collar to the end wall of the casing in stretched and adjusted posi- 0 tion to form an air-tight seal therewith, an adjustable head rest exterior to said casing for supporting the head of the patient in alignment with said body support and means for periodically varying the pressure within said casing.

7. In apparatus for producing artificial respiration, a casing ada ted to receive the body of a patient with t e head projecting therefrom, said casing having an opening for access to the interior, a door closing said opening, means for forming an air-tight seal when said door is closed, a body support within said casin ,a stretchable and adjustably positioned exible collar arranged to form an air-tight seal around the neck of the patient, means for clamping said collar to the end wall of the casing in stretched and adjusted position to form an air-ti ht seal therewith, and means for periodica y varying the pressure within said casing.

In testimony whereof we have afiixed our signatures to this specification. I

PHILIP DRINKER. LOUIS AGASSIZ SHAW. 

